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1 Introduction 1.1 What This Chapter Covers Children and Young People: introduction | 1 1 Introduction 1.1 What this chapter covers This chapter presents data on issues affecting the health and wellbeing of children and young people in the London Borough of Hackney and the City of London. The analysis identifies areas of unmet need through examination of health inequalities and by comparing local data with other areas and over time. The chapter also outlines the evidence for what works in meeting children and young people’s health needs, and describes key services and support available locally with regards to prevention, identification and care/treatment. Much of the information contained within this chapter has been drawn from two health needs assessments conducted over the period 2015-2016 – one for 0-5 year olds, and the other for 5-19 year olds. These needs assessments can be found on the Hackney Council website. 1 The main local services for children and young people are listed within this chapter to highlight the range of support that is available. However, this is not intended to be a comprehensive directory of all local services. To search for further services in Hackney, please consult the ‘Children & Young People’s Resource Guide’, which has recently been updated (July 2016) by Hackney Children’s and Young People’s Services (CYPS).2 Please note, given the small number of children and young people resident in the City of London, many services are shared with neighbouring boroughs. However, they are not always shared with Hackney (for instance, youth offending is shared with Tower Hamlets). Where possible, services covering the City of London have been described. However, given the wide scope of this chapter, it has not been possible to describe all of these services, particularly where they are fragmented. The chapter has been structured according to Box 1. 1 http://www.hackney.gov.uk/jsna 2 http://www.hackney.gov.uk/media/3989/CYPS-resource-guide-for-professionals/pdf/CYPSresource- guide Document Number: 17850552 Document Name: JSNA Children and young people - 01 Introduction - FINAL Children and Young People: introduction | 2 Box 1: Chapter structure Executive summary Introduction Demographics Maternal health The best start in life Pregnancy and birth Infant health Communicable diseases Non-communicable Physical health public health priorities Common long term Mental health conditions JSNA Chapter JSNA Children's social care Children and Young People's People's Young and Children Specific domains of vulnerability Vulnerable children Children with special educational needs Outcomes linked to vulnerability Primary care Use of services A&E attendances Hospital admissions Document Number: 17850552 Document Name: JSNA Children and young people - 01 Introduction - FINAL Children and Young People: introduction | 3 1.2 Notes on the data Age range Throughout this chapter, as far as possible the analysis covers those aged up to, and including, 19 years of age. However, not all available data sources cover this age range; some data cover a narrower range (such as up to and including 16 years of age) and others a wider age range (such as data up to and including 24 years of age). Throughout this report, age ranges have been reported with the data for absolute clarity. However, it should be remembered that differing age ranges do make some data non-comparable. City of London The 0-19 population is much smaller in the City of London than in Hackney. This means that some data that are available for Hackney are not available for the City of London, due to low numbers that could make the data identifiable to individual children and/or be unreliable. For instance, while some data are presented at ward level in Hackney, this is not possible for the City of London as each of the City’s 25 wards contain few, and in some cases no, residents. Furthermore, this small population size means that there are no secondary schools based within the City of London; instead, these children attend schools in a number of different neighbouring local authorities, which creates fragmented data. Statistical peers Hackney’s statistical peers are local authorities with a similar demographic make up to Hackney, used for the purpose of comparisons. The statistical peers used for comparative analysis throughout this chapter differ from those used in other parts of the JSNA, as they are designed specifically to reflect the local population of children and young people. The statistical peers used throughout this document are listed in Table 1. Table 1: Statistical peers for Hackney and for the City of London (July 2016) Hackney City of London Brent Barnet Enfield Brighton and Hove Greenwich Camden Hammersmith and Fulham Hammersmith and Fulham Haringey Islington Islington Kensington and Chelsea Lambeth Kingston upon Thames Lewisham Richmond upon Thames Southwark Wandsworth Waltham Forest Westminster Source: Local authority interactive tool [1] The statistical peers for the City of London must be used with caution, as it contains far fewer residents comparatively – each of the City’s statistical peers contains between 21 and 46 times as many residents as the City. These small numbers mean Document Number: 17850552 Document Name: JSNA Children and young people - 01 Introduction - FINAL Children and Young People: introduction | 4 that comparisons are less robust than in larger local authorities. Furthermore, some population demographics differ quite significantly; for example, the City of London has a higher proportion of working-age males and a smaller proportion of children than most of its ‘peers’. Therefore, for convenience, throughout this chapter the City’s data are most commonly presented alongside Hackney and Hackney’s statistical peers. However, where in the text the City has been compared to its own statistical peers specifically, the list in Table 1 above has been used. Independent schools Hackney and the City of London have a higher proportion of pupils being educated in independent schools (25%) than across London (10%) or nationally (7%). [2] These independent schools are outside of data collection systems for state-maintained schools, and do not routinely provide data for national programmes such as the National Child Measurement Programme (NCMP). This means that the data for some topics, such as obesity, may not cover all local children. As those who attend independent schools may differ in their health needs from other local children (for instance, those in the Stamford Hill Orthodox Jewish community), school-based data may not be fully representative. 1.3 Local population context Age and gender There are over 60 times as many children and young people aged 5-19 years (inclusive) in Hackney (44,700) than in the City of London (700). [3] Hackney has a relatively young population compared to national figures, with a greater proportion of people under 40 years of age, and a smaller proportion of people in each age category after 45 years of age (Figure 1). The City of London, however, has a lower proportion of children and young people under 19 years of age than nationally or in Hackney. [3] Document Number: 17850552 Document Name: JSNA Children and young people - 01 Introduction - FINAL Children and Young People: introduction | 5 Figure 1: Hackney and UK population age structures (mid-2014 estimate) Source: Office for National Statistics [3] Population projections The 0-19 population is projected to increase across both Hackney and the City of London over the coming years by 800 young people per year to reach 68,900 in 2020. [4] However, as shown in Figure 2, these increases are not uniform. Within Hackney, the projected changes in 0-19 year olds vary from 50 fewer young people in Haggerston, Hackney Downs and Brownswood wards to 1,200 more young people in New River ward [4].3,4 The three wards with the highest forecast population increases are located in the Stamford Hill area of the borough – where the majority of the Charedi community are based (see Section 1.4). 3 Population changes have been calculated here using Greater London Authority (GLA) estimates for both 2014 and 2020 to allow comparability. 4 These are the pre-2014 wards as the data from GLA have not yet been updated to reflect the new ward boundaries. Document Number: 17850552 Document Name: JSNA Children and young people - 01 Introduction - FINAL Children and Young People: introduction | 6 Figure 2: Projected change in 0-19 population by Hackney ward (pre-2014 boundaries) and City of London (2014 – 2020) New River 1,200 Lordship 500 Springfield 450 King's Park 400 City of London 350 Cazenove 350 De Beauvoir 350 Wick 350 Leabridge 300 Chatham 150 Hoxton 150 Queensbridge 50 Victoria 50 Clissold - Dalson - Hackney Central - Stoke Newington Central - Brownswood -50 Hackney Downs -50 Haggerston -50 Source: Greater London Authority [4] Sexuality National data from the 2011 Office for National Statistics (ONS) Integrated Household Survey showed that the 16-24 age group had the lowest proportion identifying as heterosexual/straight and a relatively high proportion of ‘don’t know/refusal’ or no response (Table 2). Document Number: 17850552 Document Name: JSNA Children and young people - 01 Introduction - FINAL Children and Young People: introduction | 7 Table 2: Sexual identity by age group, national data (2010/11) 16 -24 25 -34 35 -49 50 -64 65+ Heterosexual/straight 91.4 93.6 94.0 95.2 94.7 Gay/lesbian 1.1 1.4 1.4 0.7 0.3 Bisexual 1.0 0.6 0.4 0.3 0.3 Other 0.3 0.3 0.3 0.3 0.5 Don’t know/refusal 4.9 3.4 3.2 2.9 3.9 No response 1.3 0.7 0.7 0.6 0.3 Source: Integrated Household Survey , Office for National Statistics [5] 1.4 Young people’s ethnicity and migration Ethnicity The 0-19 population is more ethnically diverse than the general population across England and this is more pronounced in Hackney, the City of London and London overall (Figure 3).
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